Abstract: Background: Sotrovimab, a monoclonal antibody, is among the approved therapies for coronavirus disease – 2019 (COVID-19). Sotrovimab binds to the spike protein of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and inhibits virus attachment to human cells. Real-life experience about the effectiveness of Sotrovimab is limited. We aimed to evaluate the efficacy of Sotrovimab in preventing COVID-19 hospitalizations and other patient-related outcomes as well as the appropriateness of use in an academic hospital in Lebanon. Methodology: In this retrospective observational study, we included adult patients with positive test results for SARS-CoV-2 who received intravenous (IV) Sotrovimab at the American University of Beirut Medical Center (AUBMC) from November 2021 through March 2022. The data collected included patient demographics and comorbidities. Primary outcomes were hospitalization, deterioration after 24 hours, and death due to any cause up to 60 days after the Sotrovimab infusion. Secondary outcomes were progression to critical illness and adverse events. Results: A total of 62 subjects received Sotrovimab infusion at our hospital. More than 50% of the patients had a malignancy. About 77% of the cohort belonged to Tier 1 of the National Institutes of Health (NIH) criteria for Sotrovimab use, and 21% of the patients had clinical deterioration 24 hours after Sotrovimab infusion. The percentage of progression to critical disease was 9.7% and the mortality 6.5 %. Conclusion: Sotrovimab is effective against COVID-19 infection and prevents mortality in high-risk patients.